Translation

?well worth reproducing in English.?Edts., I. M. Gazette.] On the loss of the epithelium of the intestinal canal, consequent on the excessive secretion of fluid from its surface. We are all well acquainted with the fact, that in certain diseases the outer layers of the epithelial cells protecting the skin are thrown off in flakes ; and I believe that it is the same in Asiatic cholera as regards epithelial cells lining the surface of the jntestinal mucous membrane?a matter of greater pathological significance than that concerning the skin, because the intestinal epithelium is intended to guard more delicate and important structures than the cells that cover the cutis. The symptoms of cholera, however, are very much dependent on this desquamation of the epithelia?a fact which may be demonstrated by the aid of the microscope; but we are not to suppose that all parts of the intestinal canal are equally affected in cholera. The epithelium of the stomach suffers less than that of the intestines, and the upper part of the small intestines is not so deeply involved in the disease as the lower part of the ileum. In the duodenum, where the peristaltic action of the canal is not very strong, you often find the epithelial cells lining the mucous membrane ; the cells are loosened, but riot detached, because this part of the canal has less mechanical work to do than the lower portion of the gut. The valvulae conniventes (kerkring), which are large and closely approximated in the second part of the duodenum, protect by covering in the epithelial celh that lie between them, but on the surface of these folds wo shall observe the commencement of the desquamative process which is so marked in the ileum. We shall see with the naked eye that the epithelium, which should cover the valvulae conniventes, has disappeared in places, leaving small isolated patches of the denuded mucous membrane. In their early stages, these spots are distinguishable by their whiter colour, and by a soft velvet-like texture, which may be well demonstrated if a spot of this kind is isolates1, and fixed on a plate under the object glass of the microscope, little water being allowed to trickle over it. You may also in this way examine the villi, which are clearly denuded of epithelial cells in the patches of the valvulae conniventes above referred to. In some parts wo notice that a space evidently extends through the length of the villi, and externally the villi are covered